Initiating or switching to insulin degludec/insulin aspart in a real-world population of adults with type 2 diabetes in Australia: results from a prospective, non-interventional study.

Background: Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec and insulin aspart for the treatment of people with diabetes and suboptimal glycaemic control. Few real-world studies of IDegAsp treatment have been conducted. Here, we report results from the Australian cohort of the global ARISE study of real-world IDegAsp use.

Improvements in image quality after optimization in digital intraoral radiographs.

Background: Digital intraoral radiographic exposures are optimized largely on the basis of subjective assessment of diagnostic image quality. This study presents an objective approach to optimize radiographic exposure settings for digital intraoral radiographic systems.

Methods: Seven size 2 digital intraoral systems were assessed for image quality and determination of optimal exposure following the protocol specified in American National Standard Institute/American Dental Association Standard No.

The importance of the ANSI ADA Standard for digital intraoral radiographic systems-a pragmatic approach to quality assurance.

The need for quality assurance (QA) for digital dental radiography has existed since the introduction of digital imaging; however, the methods and phantoms required to achieve it were not available. This resulted in a chaotic approach to address QA based largely upon subjective analysis of image quality. The American National Standards Institute (ANSI)/American Dental Association (ADA) Quality Assurance Standard 1094 for Digital Intraoral Radiographic Systems (DIRS) presents a paradigm shift to a scientific and objective method of QA rather than one based on subjective assessments.

The effectiveness of in-hospital interventions on reducing hospital length of stay and readmission of patients with Type 2 Diabetes Mellitus: A systematic review.

Aim: This review aimed to assess the effectiveness of multifaceted in-hospital interventions for patients with type 2 diabetes mellitus on hospital readmission, hospital length of stay (LOS), and glycated haemoglobin (HbA1c).

Methods: The search included MEDLINE, EMBASE, Emcare, Web of Science, PsycINFO and Google Scholar from 2007 to current date and restricted to English. The differences in outcome measures were calculated to determine the effectiveness.

Image-based characterization of powder flow to predict the success of pharmaceutical minitablet manufacturing.

Powder flowability plays an important role in die filling during tablet manufacturing. The present study introduces a novel small-scale measuring technique for powder flow. Based on image analysis, the flow was defined depending on the variation of luminous intensity and the movement of powder inside the measurement cuvette.

Quality assurance: acceptance testing for digital dental intraoral sensors.

Objective: The aim of this study was to demonstrate the need for acceptance testing with digital dental intraoral sensors (DIOS) as the first step of a comprehensive quality assurance (QA) program.

Study Design: Five commercially available DIOS were tested by using a QA test phantom, satisfying the requirements for intraoral QA testing as specified in American Dental Association Technical Report No. 1094 (TR 1094).

The use of hydrophobic amino acids in protecting spray dried trehalose formulations against moisture-induced changes.

Trehalose is commonly used as a protein stabilizer in spray dried protein formulations delivered via the pulmonary route. Spray dried trehalose formulations are highly hygroscopic, which makes them prone to deliquescence and recrystallization when exposed to moisture, leading to impairment in aerosolization performance. The main aim of this study was to investigate and compare the effect of hydrophobic amino acids (i.

A Design of Experiment (DoE) approach to optimise spray drying process conditions for the production of trehalose/leucine formulations with application in pulmonary delivery.

The present study evaluates the effect of L-leucine concentration and operating parameters of a laboratory spray dryer on characteristics of trehalose dry powders, with the goal of optimizing production of these powders for inhaled drug delivery. Trehalose/L-leucine mixtures were spray dried from aqueous solution using a laboratory spray dryer. A factorial design of experiment (DoE) was undertaken and process parameters adjusted were: inlet temperature, gas flow rate, feed solution flow rate (pump setting), aspiration setting and L-leucine concentration.

Elucidation of Compression-Induced Surface Crystallization in Amorphous Tablets Using Sum Frequency Generation (SFG) Microscopy.

Purpose: To investigate the effect of compression on the crystallization behavior in amorphous tablets using sum frequency generation (SFG) microscopy imaging and more established analytical methods.

Method: Tablets containing neat amorphous griseofulvin with/without excipients (silica, hydroxypropyl methylcellulose acetate succinate (HPMCAS), microcrystalline cellulose (MCC) and polyethylene glycol (PEG)) were prepared. They were analyzed upon preparation and storage using attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy, scanning electron microscopy (SEM) and SFG microscopy.

The effect of surfactants on the dissolution behavior of amorphous formulations.

The optimal design of oral amorphous formulations benefits from the use of excipients to maintain drug supersaturation and thus ensures adequate absorption during intestinal transit. The use of surfactants for the maintenance of supersaturation in amorphous formulations has not been investigated in detail. The main aim of this study was to investigate the effect of surfactant on the dissolution behavior of neat amorphous drug and binary polymer based solid dispersion.

Differential scanning calorimetry predicts the critical quality attributes of amorphous glibenclamide.

Selection of a crystallinity detection tool that is able to predict the critical quality attributes of amorphous formulations is imperative for the development of process control strategies. The main aim of this study was to determine the crystallinity detection tool that best predicts the critical quality attributes (i.e.

Digital intraoral radiographic quality assurance and control in private practice.

At present, the American Dental Association and the American Academy of Oral Maxillofacial Radiology have guidelines for the dental environment that include quality assurance and control of film-based radiography. Approximately 19%-30% of US dental offices currently use some form of digital intraoral radiography, and growth is expected to continue. It is anticipated that new tools and guidelines will be needed to aid in the development of quality assurance (QA) and control of digital intraoral radiographic images.

Quantification and genotyping of lipoprotein lipase in patients with diabetic lipaemia.

Aims: To determine if diabetic lipaemia is caused by loss of function mutations in the lipoprotein lipase gene, LPL.

Methods: We conducted a case-control study over 2 years in two tertiary care hospitals in South Australia. Six patients with a history of diabetic lipaemia and 12 control subjects, with previous diabetic ketoacidosis and peak triglyceride concentrations < 2.

Coherent anti-Stokes Raman scattering microscopy driving the future of loaded mesoporous silica imaging.

This study reports the use of variants of coherent anti-Stokes Raman scattering (CARS) microscopy as a novel method for improved physicochemical characterization of drug-loaded silica particles. Ordered mesoporous silica is a biomaterial that can be loaded to carry a number of biochemicals, including poorly water-soluble drugs, by allowing the incorporation of drug into nanometer-sized pores. In this work, the loading of two poorly water-soluble model drugs, itraconazole and griseofulvin, in MCM-41 silica microparticles is characterized qualitatively, using the novel approach of CARS microscopy, which has advantages over other analytical approaches used to date and is non-destructive, rapid, label free, confocal and has chemical and physical specificity.

Characterization of atherosclerotic plaque: a contrast-detail study using multidetector and cone-beam computed tomography.

A Hindmarsh-Rose model perceptibility phantom containing inserts with various in vitro atherosclerotic plaque compositions was constructed and imaged on a clinical 64 slice multidetector (MDCT) system using 80 and 120 kVp settings and two other cone-beam (CBCT) systems at 80 kVp. Perceptibility of the simulated lipid-fibrotic plaque solutions in the images was evaluated by six observers. The effective doses of the protocols employed were estimated using phantom CTDI-vol measurements placed at identical settings.

Evaluation of image quality parameters of representative intraoral digital radiographic systems.

Objective: The aim of this study was to compare imaging properties of 20 intraoral digital systems objectively.

Study Design: Using a direct current x-ray source and a radiographic phantom, a series of radiographs was made from the lowest exposure time until the sensor saturated. Images were captured and stored.

Unravelling the relationship between degree of disorder and the dissolution behavior of milled glibenclamide.

Milling is an attractive method to prepare amorphous formulations as it does not require the use of solvents and is suitable for thermolabile drugs. One of the key critical quality attributes of milled amorphous formulations is their dissolution behavior. However, there are limited studies that have investigated the relationship between degree of disorder induced by milling and dissolution behavior.

Microparticle-associated tissue factor is recycled by endothelial cells resulting in enhanced surface tissue factor activity.

In this study the uptake of tissue factor (TF)-positive microparticles by endothelial cells and the recycling of the TF component were examined. Human dermal blood endothelial cells (HDBEC) were incubated with microparticles derived from cancer cell lines for up to 6 hours. Measurement of HDBEC cell surface TF antigen revealed two distinct peaks at 30 and 180-240 minutes post-incubation with TF-positive, but not TF-deficient microparticles.

Deriving Hounsfield units using grey levels in cone beam CT: a clinical application.

Objective: To present a clinical study demonstrating a method to derive Hounsfield units from grey levels in cone beam CT (CBCT).

Methods: An acrylic intraoral reference object with aluminium, outer bone equivalent material (cortical bone), inner bone equivalent material (trabecular bone), polymethlymethacrylate and water equivalent material was used. Patients were asked if they would be willing to have an acrylic bite plate with the reference object placed in their mouth during a routine CBCT scan.

Quality assurance phantom for digital dental imaging.

Objective: The purpose of this research was to develop a simple quality assurance phantom that could be used for the initial calibration and follow-up testing of commercially available intraoral digital imaging systems.

Study Design: A radiographic phantom was constructed that contains a calibrated step wedge for measuring dose response, an etched pattern of slits in a metallic background for measuring the spatial resolution in line pairs per millimeter, and 2 rows of wells of varying diameter and depth in an acrylic background for contrast-detail analysis. Quality assurance protocols were developed and validated.

Deriving Hounsfield units using grey levels in cone beam computed tomography.

Objectives: an in vitro study was performed to investigate the relationship between grey levels in dental cone beam CT (CBCT) and Hounsfield units (HU) in CBCT scanners.

Methods: a phantom containing 8 different materials of known composition and density was imaged with 11 different dental CBCT scanners and 2 medical CT scanners. The phantom was scanned under three conditions: phantom alone and phantom in a small and large water container.

Obesity and testicular function.

Obesity in men, particularly when central, is associated with lower total testosterone [TT], free testosterone [FT] and sex hormone-binding globulin [SHBG], and a greater decline in TT and FT with increasing age compared with lean men. Obesity-related conditions such as obstructive sleep apnea, insulin resistance and type 2 diabetes mellitus are independently associated with decreased plasma testosterone. Possible mechanisms include decreased LH pulse amplitude, inhibitory effects of oestrogen at the hypothalamus and pituitary and the effects of leptin and other peptides centrally and on Leydig cells.

Double-blind placebo-controlled study of testosterone patch therapy on bone turnover in men with borderline hypogonadism.

Clinical studies suggest there may be a threshold concentration of serum testosterone below which replacement will result in skeletal and psychological benefit. We evaluated the response to testosterone in men with borderline hypogonadism. A randomized double-blind placebo-controlled trial in 39 men over age 40 years presenting with sexual dysfunction and a borderline low testosterone level (total testosterone <10 nmol/L or free androgen index <30%).